Project Summary/Abstract Research indicates that pediatric obesity prevalence is high among all children, but that children from rural areas are disproportionately affected. There are very few interventions specifically targeting pediatric obesity treatment among rural children, a factor that contributes to this health disparity. Previous research from our lab indicates that mHealth is feasible and acceptable for the delivery of pediatric obesity interventions to rural children as this type of intervention lowers child Body Mass Index z score (BMIz) and helps children and families to significantly change their health behaviors. The current application extends this work in a new and innovative direction by moving the mHealth intervention into rural family homes, increasing convenience and dose simultaneously. The intervention is composed of both group and individual family level components, based upon new research that indicates this combination is highly effective. Finally, the composition of the intervention groups is also innovative as they will be composed of children from the same school, making individual level factors as well as factors clustered at the school level addressable in one intervention. The current study proposes to compare the effectiveness of two active interventions: iAmHealthy vs. control (a newsletter control group) using in cluster-randomized design. iAmHealthy is a 32 week behavioral intervention focused on nutrition, behavior and physical activity that engages parents and children in treatment using mHealth technology. It combines family based behavioral groups with individual level child and family support ? all provided directly to homes via mHealth technologies. Children and families meeting inclusion criteria from a total of 18 schools will be randomly assigned by school to condition, with at least 8 families participating at each rural school, for a total of 144 child and 144 adult participants. We hypothesize that: the iAmHealthy intervention will result in significantly greater improvement in food choices than the active control intervention (as indicated by servings of sugar sweetened beverages, number of servings of ?red foods,? and number of servings of fruits and vegetables); the iAmHealthy intervention will result in significantly greater improvement in levels of physical activity than the control intervention (as indicated by change in number of minutes of moderate/vigorous physical activity); and, that the iAmHealthy intervention will result in significantly greater improvement in child BMIz and parent BMI than the control intervention. Aim 2 uses the RE-AIM framework to measure the effectiveness of iAmHealthy. iAmHealthy is an easily scalable, widely disseminable pediatric obesity intervention option for rural children and families, if found to be effective; the results of the current study could significantly alter the way we treat pediatric obesity among high risk and underserved rural children.